Beating Bipolar Depression in Grad School

This week’s blog post was written by AMHC reader Sam.

Before I entered university, I had the notion that it would be the best experience of my life. I would be a top student, have an active social life, and be involved in all sorts of exciting and new activities. I believed that if I set my mind to it, I could be anything I wanted: a researcher, a doctor, a lawyer, or maybe all three. And that’s exactly how the beginning of my academic career went. I easily transitioned into university and was able to maintain my grades. I made a large group of friends that I regularly spent time with. I volunteered in my free time.

Something in me started to change

However, something in me started to change. I chalked it up to the stress of university. Slowly, I started cutting back my responsibilities in order to better cope. First, I stopped volunteering, and then I stopped socializing outside of class. I started berating myself over anything I could think of. I started crying more frequently. My mantra became “I’m just tired” and I repeated it over to myself and to anyone who questioned the obvious change in me. This was not a lie, as I was not sleeping well. But, it wasn’t necessarily the truth either. I began experiencing a great deal of anxiety and regret throughout the day that made it difficult to keep up with all my classes. My thoughts became much darker and it was almost impossible to keep them off of my mind.

In my mind, it seemed that there was no point in seeing a doctor

As my depression progressed, I began to experience delusions. Slipping deeper into depression I somehow came to the conclusion that I had an incurable disease and that this was my well-deserved punishment for my “sins” (my perceived wrongdoings). Whenever something came up that had to do with my condition, I saw confirmation that I was indeed dying and being punished. Shows on television and internet ads were placed there to tell me I was dying. Songs were played on the radio to me that I was dying and that I should harm myself. I obsessed constantly and was only able to sleep a few hours a night. In my mind, it seemed that there was no point in seeing a doctor. I felt that there was nothing they could do anyways. I couldn’t tell anyone what I thought, because I was worried that they would find out about all my sins and wrongdoing, and agree that I should be dying from this disease.

I didn’t think it could, or would, get this bad

It was during this episode in my first year of university that I would be diagnosed with bipolar disorder. This was not a surprise, as I had my suspicions after experiencing what I eventually recognized to be mania, and moderate depression thereafter. However, I didn’t think it could, or would, get this bad. Up until this point, I didn’t actually didn’t think I was ill. I thought what I had experienced were isolated events that I had handled reasonably well on my own. It was a diagnosis I couldn’t accept at the time, and still have a great deal of trouble accepting. Even with a brief medication trial and psychotherapy, it would be almost a year until I started to feel like myself again.

Shortly before starting my grad degree, I stopped taking medication

In spite of this diagnosis, and a rather tumultuous personal life, I had a moderately successful undergraduate tenure characterized by mostly good grades, a few notable scholarships, and a prestigious research opportunity. However, that is not to say that I did not struggle through it. I completed my undergraduate degree largely unmedicated, which in hindsight was a bad decision as it created a vast amount of unnecessary stress and suffering. When I was medicated, things generally ran more smoothly and stress was much better tolerated. Shortly before starting my graduate degree, I stopped taking the medication to which I’d been regularly adhering for a year. This decision, made with my doctor’s permission, was motivated by the fact that the benefits of medication seemed to be outweighed by negative side effects, as well as the odd discomfort I felt during periods of emotional equilibrium. Things went well fairly well in my first year as a graduate student, and as my research began to pick up and responsibilities were piled on, I stopped going to psychotherapy too. As you may have guessed, this was a poor decision on my part.

I knew something wasn’t right

Things slowly started coming apart, both at school and at home. While I should have recognized the signs of a returning depression, I somehow missed it once again, even though I knew something wasn’t right at the back of my mind. Perhaps in some sort of desperate effort, I tried to take up yoga, as a good friend swore by it to reduce anxiety and depression. But even my daily yoga practice couldn’t fend off the dark thoughts brewing in my mind.

Looking from below the blue water’s surface, countless air bubbles of different sizes float upwards towards s stream of sunlight

I knew I needed help, but I was scared

On a walk home from yoga practice, I became convinced that I had committed a horrendous crime (with no basis in reality), that I needed to turn myself into the police, and that I deserved to be killed by the other inmates for what I had done. This episode progressed much like depression I had experienced during my first year in university. Things started appearing in the news and on the internet that I interpreted as signs telling me these thoughts were all true and that everyone knew what I had done. I started to fear that the police were monitoring my computer for evidence that I had committed a crime or was planning on committing another crime. After many sleepless nights, I eventually broke down and told my boyfriend, who is the most rational, sympathetic, and patient person I have ever met. He tried unsuccessfully to help me reality-test my thoughts. I didn’t understand how he could not see that I was a horrible criminal and deserved to die. By this point, my mind was plagued not only by pathological guilt, but also thoughts of suicide. I knew I needed help, but I was too scared to tell anyone else what was going on in case they believed me and sent me to jail. Eventually, I was able to see my psychiatrist, who quickly realized what was going on. I started medication and after about a month started to feel better.

Can my supervisor tell that I have bipolar disorder?

It’s been over a year since my last episode, and I feel much more like my old self again. However, the past episode has lead to some serious life questioning. Is academia really right for me? Can I continue to handle the high stress and be able to manage my mood? Will I ever be able to hold down a normal job? Can my supervisor tell that I have bipolar disorder, even though I have never outright admitted to it? Am I going to have another episode? Based on my history, the answer to the last question is almost inevitably yes, I will eventually have another episode.

Living with a serious mental illness as a young adult has proven to be challenging, but not insurmountable

Being diagnosed with bipolar disorder has left me with more questions than it has given me answers. Because many of these questions can only be answered by the future, it is difficult to plan far ahead in my personal and professional life. I would still like to believe that if I put my mind to it, I could be anything I want: a researcher, a doctor, a lawyer, or maybe all three. But, I am also aware that the stress of pursuing even one of the above is likely to precipitate another episode. It is difficult to accept that my future may not be exactly how I imagined it and it is frustrating to know that I am sometimes delayed in reaching my goals because of my bipolar disorder. Living with a serious mental illness as a young adult has proven to be challenging, but not insurmountable. There is still a lot I have yet to learn on how best to manage my condition while striving towards a fulfilling life.

Is anyone else in the early years of their condition (or diagnosis) and grappling with similar questions?

Are there others who have dealt with this and are able to comment on what has worked for them?